Individual
MRS. THERESA BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CNM
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
APRN3194502
FL
367A00000X
Advanced Practice Midwife
Primary
APRN3194502
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001180900
—
FL
01
—
Y02ET
BCBSFL
FL
Enumeration date
07/27/2006
Last updated
11/21/2018
Update your record
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